Caregivers, Depression, Anxiety, Functionally-Impaired Elderly, Intensive Care Unit Syndrome, PTSD
Conditions
Brief summary
It is known from extensive documentation that second victims in critical illness often are the care givers of the patients: family, friends or other persons. Although this has not been specifically studied in the very old patients, there is no reason to believe that this group will be different from other ICU patients. Even more so, in this very old age patient group there are seldom any older relatives. Partners, like wife/husband or other cohabitants, may be dead or themselves incapacitated. Many will be in institutional care. The closest care-givers will be middle-aged people such as children or others, if no partners are available. The hypothesis is that critical illness can be a large stressor to care-givers of survivors in the VIP measured as the occurrence and severity of the usual problems like PTSD and depression. The investigators hypothesize that a low-threshold on-line support program decreases the magnitude of anxiety, depression and PTSD for care-givers of very old intensive care patients (VIP) after discharge.
Detailed description
Aims of the study * Results from family/care givers experience: Degree of involvement with post-ICU care, impact on their own health (depression, PTSD, burden questionnaire) * Effect of a simple intervention: on-line support and/or telephone advice on Return to pre-ICU frailty score (patients) and Occurrence of PTSD and depression in care-givers * Information on 6 months' outcome (frailty and mortality) in very old survivors after ICU in different European countries * Information on trajectories in the time after discharge: Dead/alive, home, nursing home, new hospital admissions, living with family/other care-givers, etc.
Interventions
OTHERTelephone support on demand
Dedicated phone number for help and advice for caregivers
Sponsors
European Society of Intensive Care Medicine
University of Bergen
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
Multicentre study with ≥ 100 ICUs from Europe. Randomisation at ICU level to give support to caregivers or not (cluster-randomisation)
Eligibility
Sex/Gender
ALL
Age
80 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Hospital survivors after any ICU admission
Exclusion criteria
* Imminent terminal care
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Burden scale for Family Caregiver | 6 months post ICU discharge | In order to assess the burden of care the investigaors will use an European questionaire developed within the EU and freely available online: Assessment of subjective burden of informal caregivers (http://www.psychiatrie.uk-erlangen.de/index.php?id=11049/) available in 20 European languages |
| Post traumatic stress (PTSD) in caregivers | 6 months post ICU discharge | The study will use PTSD questionnaire PTSS-14 as described at www.sthk.nhs.uk/library/documents/7308450\_ptss14.pdf. |
| Anxiety and Depression in caregivers | 6 months post ICU discharge | The investigators will use the Hospital anxiety and depression scale, a questionaire often used out of hospital as well. It is a simple questionaire that will be delivered to the care-givers after 6 months. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 6 months survival in the elderly ICU survivors | 6 months post ICU discharge | Time of death in non-survivors (patients) will be sought through administrative hospital data (when available) or from care-givers |
| Trajectories in the elderly ICU survivors | 6 months post ICU discharge | The investigators will seek to describe where the patients have been after hospital discharge: like rehabilitation facilities, nursing home, togehter with care-givers or in their own home. |
Outcome results
None listed